Background: Thoracic and lumbar fractures represent nearly 90% of traumatic spine injuries. Thoracolumbar region is susceptible to injury because of its location between the stiff kyphotic thoracic spine and the mobile lordotic lumbar region. To compare between short-segment fixation with screws into index level and long-segment fixation in maintaining angle of correction and pain. Methods: A prospective study included 91 patients, who had single-level thoracolumbar fracture with Cobb's angle ≤ 25°and underwent posterior fixation. Forty-four patients underwent short-segment fixation with screws into the index level, and 47 patients underwent long-segment fixation with skipped index level. The angle of correction, pain, and neurological state were regularly assessed. Results: Forty-four patients (48.35%) had short segment and 47 (51.65%) had long-segment fixation. In the short segment group, the pre-operative mean Cobb's angle was 19.34°± 3.63°and the angle of correction was 8.14°± 1.9°a fter 1 year, while in the long segment group, the pre-operative mean Cobb's angle was 19.08°± 4.0°and the angle of correction was 8.62°± 2.59°. Regarding pain, in the short segment group, the pre-operative visual analogue scale (VAS) was 5.59 ± 2.09 that was reduced to 1.39 ± 0.58 at the 1 year follow-up, while the long segment group VAS was 5.4 ± 2.01 pre-operatively that was reduced to 1.47 ± 0.58. Conclusions: Short-segment fixation can maintain the angle of correction as long-segment fixation for single level thoracolumbar traumatic fracture with lower complication and faster pain relief. Trial registration: Clinicaltrials.gov/NCT03272243.
Background
Meningioma arising from locations in the vicinity of optic nerve or chiasm may affect the visual function which sometimes the presentation of such tumors. Decompression of the optic nerve or chiasm can give a chance to the visual function to recover.
Methods
30 patients who had visual function affection and underwent meningioma excision are followed up for a period of one year with regular follow of their visual function periodically.
Results
In this study, females were more prevalent than males, 24 out of 30, age ranged from 24 to 72 years at the time of surgery, half the patients (15) presented with visual deterioration, the other patients presented with headache, seizure, proptosis or accidentally discovered. 22 patients improved concerning their visual function over time, 6 patients had stationary course and 2 patients deteriorated postoperatively.
Conclusion
Follow up of patients after surgical excision of meningioma compressing the anterior optic pathway showed gradual improvement in vision in follow up period up to one year, although the improvement in visual function showed a surge in early postoperative period, with continuous less steep improvement afterwards till the end of the observation period. Surgical excision of meningiomas compressing the anterior visual pathway give chance for recovery of visual function, more in younger patients, patients with shorter period of visual deterioration, patients with mild affection of the preoperative visual status. No statistically significant influence of tumor site, size, degree of excision and surgical approach on the postoperative visual outcome in this series.
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